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European Heart Journal. Acute Cardiovascular Care

Cheuk-Kit Wong, Harvey D White
Electrocardiogram sub-studies from the Hirulog Early Reperfusion/Occlusion 1 and 2 trials, which tested bivalirudin as an adjunctive anticoagulant to fibrinolysis in ST-elevation myocardial infarction, have contributed to the literature. The concept of using the presence of infarct lead Q waves to determine reperfusion benefit has subsequently been explored in multiple primary percutaneous coronary intervention studies. The angiographic findings before percutaneous coronary intervention combine with the baseline electrocardiogram to accurately diagnose ST-elevation myocardial infarction and evaluate its potential territory...
August 17, 2018: European Heart Journal. Acute Cardiovascular Care
Rosa Agra-Bermejo, Alberto Cordero, Moisés Rodríguez-Mañero, Jose M García Acuña, Belén Álvarez Álvarez, Álvaro Martínez, Leyre Álvarez Rodríguez, Charigan Abou-Jokh, Belén Cid Álvarez, Jose Ramón González-Juanatey
BACKGROUND: Recent studies suggest that the benefit of mineralocorticoid receptor antagonists in the acute coronary syndrome setting is controversial. The aim of this study was to examine the current long-term prognostic benefit of mineralocorticoid receptor antagonists in patients with acute coronary syndrome. MATERIAL AND METHODS: We conducted a retrospective cohort study of 8318 consecutive acute coronary syndrome patients. Baseline patient characteristics were examined and a follow-up period was established for registry of death, major cardiovascular adverse events and heart failure re-hospitalization...
August 17, 2018: European Heart Journal. Acute Cardiovascular Care
Matilde Winther-Jensen, Jesper Kjaergaard, Christian Hassager, Lars Køber, Freddy Lippert, Helle Søholm
OBJECTIVE: As the prevalence of malignancies in the general population increases, the odds of an out-of-hospital cardiac arrest (OHCA) patient having a history of cancer likewise increases, and the impact on post-cardiac arrest care and mortality is not well known. We aimed to investigate 30-day and 1-year mortality after successful resuscitation in patients with cancer prior to OHCA compared with OHCA patients without a previous cancer diagnosis. METHODS: A cohort of 993 consecutive OHCA patients with successful resuscitation during 2007-2011 was included...
August 10, 2018: European Heart Journal. Acute Cardiovascular Care
Thomas A Zelniker, Christian T Ruff, Stephen D Wiviott, Jean-Jacques Blanc, Riccardo Cappato, Francesco Nordio, Michele F Mercuri, Hans Lanz, Elliott M Antman, Eugene Braunwald, Robert P Giugliano
BACKGROUND: The relative efficacy and safety profile of the oral Factor Xa inhibitor edoxaban compared with warfarin in patients with atrial fibrillation and established coronary artery disease (CAD) has not been analyzed. MATERIALS AND METHODS: In the ENGAGE AF-TIMI 48 trial, two edoxaban regimens were compared with warfarin in 21,105 patients with atrial fibrillation and CHADS2 ⩾2. We analyzed the primary trial endpoints (efficacy: stroke or systemic embolic event, safety: International Society on Thrombosis and Haemostasis major bleeding) in patients with versus without CAD, and used interaction testing to assess for treatment effect modification...
July 24, 2018: European Heart Journal. Acute Cardiovascular Care
Ryan A Watson, Erin A Bohula, Thomas C Gilliland, Pablo A Sanchez, David D Berg, David A Morrow
BACKGROUND: The changing landscape of care in the Cardiac Intensive Care Unit (CICU) has prompted efforts to redesign the structure and organization of advanced CICUs. Few studies have quantitatively characterized current demographics, diagnoses, and outcomes in the contemporary CICU. METHODS: We evaluated patients in a prospective observational database, created to support quality improvement and clinical care redesign in an AHA Level 1 (advanced) CICU at Brigham and Women's Hospital, Boston, MA, USA...
July 1, 2018: European Heart Journal. Acute Cardiovascular Care
Tobias Wengenmayer, Daniel Duerschmied, Erika Graf, Marco Chiabudini, Christoph Benk, Sven Mühlschlegel, Alois Philipp, Matthias Lubnow, Christoph Bode, Dawid Leander Staudacher
AIMS: Several scoring systems have been introduced for prognostication after initiating venoarterial extracorporeal membrane oxygenation (VA-ECMO) therapy. However, static scores offer limited guidance once VA-ECMO is implanted, although continued allocation of healthcare resources is critical. Patients requiring continued VA-ECMO support are extremely unstable, with minimal heart function and multi-organ failure in most cases. The aim of the present study was to develop and validate a dynamic prognostic model for patients treated with VA-ECMO...
July 1, 2018: European Heart Journal. Acute Cardiovascular Care
Yader Sandoval, Stephen W Smith, Anne Sexter, Karen Schulz, Fred S Apple
AIMS: First, describe how acute myocardial infarction criteria are used to diagnose type 1 (T1MI) and 2 (T2MI) myocardial infarction. Second, determine whether subjective or objective criteria are used for T2MI. Third, examine outcomes for T2MI based on the presence or absence of objective evidence of myocardial ischemia compared with myocardial injury. METHODS AND RESULTS: Post-hoc analysis of UTROPIA (NCT02060760), a prospective, observational, cohort study involving 1640 consecutive emergency department patients with serial high-sensitivity cardiac troponin I among whom 74 (4...
July 1, 2018: European Heart Journal. Acute Cardiovascular Care
Giancarla Scalone, Giampaolo Niccoli, Filippo Crea
Myocardial infarction with non-obstructive coronary arteries (MINOCA) is a syndrome with different causes, characterised by clinical evidence of myocardial infarction with normal or near-normal coronary arteries on angiography. Its prevalence ranges between 5% and 25% of all myocardial infarction. The prognosis is extremely variable, depending on the cause of MINOCA. The key principle in the management of this syndrome is to clarify the underlying individual mechanisms to achieve patient-specific treatments...
June 1, 2018: European Heart Journal. Acute Cardiovascular Care
Paul M Haller, Kris G Vargas, Maria C Haller, Edita Piackova, Johann Wojta, Mariann Gyöngyösi, Bernard J Gersh, Attila Kiss, Bruno K Podesser, Kurt Huber
BACKGROUND: The efficacy of remote ischaemic conditioning in clinical trials of ST-segment elevation myocardial infarction (STEMI) or elective percutaneous coronary intervention is controversial. We aimed to systematically review and meta-analyse whether remote ischaemic conditioning reduces myocardial damage in those patients. METHODS: We searched PubMed, Embase and Web of Science from inception until December 2017 for randomised clinical trials evaluating remote ischaemic conditioning versus a control group...
June 1, 2018: European Heart Journal. Acute Cardiovascular Care
Carlos L Alviar, Alejandra Gutierrez, Leslie Cho, Amar Krishnaswamy, Amr Saleh, Michael A Lincoff, Eric Roselli, Michael Militello, Venu Menon
BACKGROUND: Sodium nitroprusside is the preferred agent for the treatment of high blood pressure during acute aortic syndrome if blood pressure remains elevated after heart rate control with beta-blockers. The increasing cost of sodium nitroprusside in the USA led us to assess the efficacy and safety of intravenous clevidipine, a calcium channel blocker with quick onset of action, short half-life and significantly lower costs than sodium nitroprusside, in patients presenting with acute aortic syndrome...
June 1, 2018: European Heart Journal. Acute Cardiovascular Care
Baris Gencer, Fabio Rigamonti, David Nanchen, Roland Klingenberg, Lorenz Räber, Elisavet Moutzouri, Reto Auer, David Carballo, Dik Heg, Stephan Windecker, Thomas Felix Lüscher, Christian M Matter, Nicolas Rodondi, François Mach, Marco Roffi
BACKGROUND: Controversy remains regarding the prevalence of hyperglycaemia in non-diabetic patients hospitalised with acute coronary syndrome and its prognostic value for long-term outcomes. METHODS AND RESULTS: We evaluated the prevalence of hyperglycaemia (defined as fasting glycaemia ⩾10 mmol/l) among patients with no known diabetes at the time of enrolment in the prospective Special Program University Medicine-Acute Coronary Syndromes cohort, as well as its impact on all-cause death, myocardial infarction, stroke and incidence of diabetes at one year...
June 1, 2018: European Heart Journal. Acute Cardiovascular Care
Patrick Sulzgruber, Sebastian Schnaubelt, Lorenz Koller, Georg Goliasch, Jan Niederdöckl, Alexander Simon, Feras El-Hamid, David-Jonas Rothgerber, Johann Wojta, Alexander Niessner
BACKGROUND: The development of cardiac arrhythmias resulting in cardiac arrest represents a severe complication in patients with acute myocardial infarction. While the worsening of the prognosis in this vulnerable patient collective is well known, less attention has been paid to its age-specific relevance from a long-term perspective. METHODS: Based on a clinical acute myocardial infarction registry we analysed 832 patients with acute myocardial infarction within the current analysis...
June 1, 2018: European Heart Journal. Acute Cardiovascular Care
Astrid A Hendriks, Tamas Szili-Torok
Electrical storm is characterised by a state of severe electrical instability that occurs in a rare combination of circumstances, and may lead to multiple implantable cardioverter defibrillator shocks and haemodynamic instability, and possible death. The main goal of treating electrical storm is to eliminate the trigger and modify the substrate of the arrhythmia. The aim of this educational review is to provide information for a better understanding of the underlying mechanisms and therefore help to improve the treatment of electrical storm patients...
August 2018: European Heart Journal. Acute Cardiovascular Care
Christiaan Jm Vrints
No abstract text is available yet for this article.
August 2018: European Heart Journal. Acute Cardiovascular Care
Dylan Stanger, Vesna Mihajlovic, Joel Singer, Sameer Desai, Rami El-Sayegh, Graham C Wong
AIMS: The purpose of this study was to conduct a systematic review, and where applicable meta-analyses, examining the evidence underpinning the use of targeted temperature management following resuscitation from cardiac arrest. METHODS AND RESULTS: Multiple databases were searched for publications between January 2000-February 2016. Nine Population, Intervention, Comparison, Outcome questions were developed and meta-analyses were performed when appropriate. Reviewers extracted study data and performed quality assessments using Grading of Recommendations, Assessment, Development and Evaluation methodology, the Cochrane Risk Bias Tool, and the National Institute of Health Study Quality Assessment Tool...
August 2018: European Heart Journal. Acute Cardiovascular Care
Francesca Cesana, Leonello Avalli, Laura Garatti, Anna Coppo, Stefano Righetti, Ivan Calchera, Elisabetta Scanziani, Paolo Cozzolino, Cristina Malafronte, Andrea Mauro, Federica Soffici, Endrit Sulmina, Veronica Bozzon, Elena Maggioni, Giuseppe Foti, Felice Achilli
BACKGROUND: Extracorporeal cardiopulmonary resuscitation is increasingly recognised as a rescue therapy for refractory cardiac arrest, nevertheless data are scanty about its effects on neurologic and cardiac outcome. The aim of this study is to compare clinical outcome in patients with cardiac arrest of ischaemic origin (i.e. critical coronary plaque during angiography) and return of spontaneous circulation during conventional cardiopulmonary resuscitation vs refractory cardiac arrest patients needing extracorporeal cardiopulmonary resuscitation...
August 2018: European Heart Journal. Acute Cardiovascular Care
Matilde Winther-Jensen, Christian Hassager, Jesper Kjaergaard, John Bro-Jeppesen, Jakob H Thomsen, Freddy K Lippert, Lars Køber, Michael Wanscher, Helle Søholm
BACKGROUND: Out-of-hospital cardiac arrest is more often reported in men than in women. OBJECTIVES: We aimed to assess sex-related differences in post-resuscitation care; especially with regards to coronary angiography, percutaneous coronary intervention, mortality and functional status after out-of-hospital cardiac arrest. METHODS: We included 704 consecutive adult out-of-hospital cardiac arrest-patients with cardiac aetiology in the Copenhagen area from 2007-2011...
August 2018: European Heart Journal. Acute Cardiovascular Care
Tim Van Puyvelde, Koen Ameloot, Mieke Roggen, Els Troost, Marc Gewillig, Werner Budts, Alexander Van De Bruaene
BACKGROUND: Outcome after cardiopulmonary resuscitation (CPR) in patients with underlying congenital heart disease is uncertain. This study aimed at evaluating outcome after CPR in patients with underlying congenital heart disease, factors related to worse outcome after CPR and whether survivors of sudden cardiac death (SCD) have a worse outcome when compared to an age, gender and disease-matched control population. METHODS: Between 1984 and 2015, all patients with congenital heart disease who received in or out-of-hospital CPR were identified from the database of congenital heart disease from the University Hospitals Leuven...
August 2018: European Heart Journal. Acute Cardiovascular Care
Patrick Sulzgruber, Philip Datler, Fritz Sterz, Michael Poppe, Elisabeth Lobmeyr, Markus Keferböck, Sebastian Zeiner, Alexander Nürnberger, Andreas Schober, Pia Hubner, Peter Stratil, Christian Wallmueller, Christoph Weiser, Alexandra-Maria Warenits, Andreas Zajicek, Florian Ettl, Ingrid Magnet, Thomas Uray, Christoph Testori, Raphael van Tulder
BACKGROUND: While guidelines mentioned supraglottic airway management in the case of out-of- hospital cardiac arrest, robust data of their impact on the patient outcome remain scare and results are inconclusive. METHODS: To assess the impact of the airway strategy on the patient outcome we prospectively enrolled 2224 individuals suffering cardiac arrest who were treated by the Viennese municipal emergency medical service. To control for potential confounders, propensity score matching was performed...
August 2018: European Heart Journal. Acute Cardiovascular Care
Aitor Uribarri, Loreto Bravo, Javier Jimenez-Candil, Javier Martin-Moreiras, Eduardo Villacorta, Pedro L Sanchez
Extracorporeal membrane oxygenation systems have undergone rapid technological improvements and are now feasible options for medium-term support of severe cardiac or pulmonary failure. We report five cases of electrical storm that was rescued by the insertion of peripheral veno-arterial extracorporeal membrane oxygenation systems. This device could help to restore systemic circulation as well as permitting organ perfusion in patients with cardiogenic shock in relation to electrical storm thus achieving greater electrical stability...
August 2018: European Heart Journal. Acute Cardiovascular Care
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